I’ve been taking Flecainide 100mg twice a day and Bisoprolol 1.25 mg once a day for years now and every thing has been fine (touch wood) Unfortunately I suffer with Tinnitus and the Bisoprolol sends the volume of it through the roof for hours.
I’m seriously considering stopping taking the Bisoprolol after all it’s such a low dose. Does anyone in this group just take Flecainide with no beta blocker?
Please dont stop without speaking with your Dr.It is needed to counteract the tendency for flecanide to instigate Atrial Flutter,as it did for me when my first hospital put me on Flecanide without a betablocker.( a week later I was blue lighted into second hospital with Flutter ,heart rate heading towards 250.)
I am only on 1.25,just enough to do the job. There may be alternatives for it better suited for your tinnitus problem. X
Thanks for taking the trouble to reply. I will heed your advice.
Alternatively you can take Diltiazem as a nodal blocker for safety reasons. Serves the same function as a beta blocker here, with a different side effect profile. That's what I take.
Jim
Thanks Jim, they might be worth looking into.
If the tinnitus is causing you such discomfort, I wouldn't hesitate or wait. Both selective beta blockers and Diltiazem (a calcium channel blocker) serve the same nodal blocking function to help prevent 1:1 flutter and other dangerous arrythmia's while taking Flecainide.
Jim
Not recommnded. Flecianide can cause flutter which is why you should take a beta blocker.
Thanks for the reply. I will keep taking them.
Warning: Please do not stop taking your A/F heart meds without prior consultation with your Cardiologist, I stopped taking Disopyramide for a few months and am now back on it with a ticking off.....also Bisoporal was 2.5 now upped to 7.5 as I am in mild heart failure and permanent A/F, trying to get my heart rate down. I thought I was being clever by reducing my drugs but I wasn't so please let this be a warning to you. We have to take them for specific reasons, they have a job to do. One thing I can't fathom out, I have a Pacemaker, my last pacing in November showed slight elevation of heart rate, nothing major, my thoughts had been that if I had or went into A/F after stopping the drug(s) then it would kick off and I could then take this as a sign to bo back on them but it didn't, my heart rate felt as always, if I had felt that I was in A/F at any time I would have resumed by daily dose. I had a fall in April 2022 so wondered if that had any bearing on it at all....guess I will never know, so just keep taking the drugs and hoping for the best!!!!!
I have been taking Flecainide 50mg bd for nearly 18 years on its own. Firstly administered by i.v in hospital. Beta blockers were never mentioned or offered in the beginning or since. I didn’t know about them for years. My resting rate is late 50s and to be honest I wouldn’t want to take anything that would lower it. Thankfully I’ve never had flutter and again didn’t know for years taking flec on its own had the potential to cause it.
Have had tinnitus 24/7 in both ears for many years. Happened to mention it to gp some years back and he said “well you know flec can cause tinnitus don’t you?”erm, no, I was never told that. Thankfully I can ignore it most of the time and forget it’s there.
I think they only give betablockers to lower your rate and as that seems ok, they probably figure you can do without one.
I couldn't handle any beta blockers or calcium channel blockers and although I have flutter and exercise regularly I decided not to use them. I researched the risk of centrical tachycardia as best I could and it appears to me to be extremely low and theoretical for the majority of the population so decided that the side effects were not worth it for me. I HAVE NO MEDICAL QUALIFICATIONS OR EXPERTISE. This is my own personal decision that I'm happy works for me.
I stopped Bisoprolol with 2 x 50 mg (Flecainide) daily in consultation with my EP due to its impact on my ability to exercise. This was done on basis of QOL.
I take it you mean 5mg daily? I was on 5mg twice a day which made me breathless, lacking energy and needing to sleep/rest. Came off it a week ago and onto Sotalol which seems to have got rid of these issues.
Sorry - should have made it clearer that the 2 x 50 mg was in relation to the Flecainide I was on. I will edit my original entry and add (Flecainide)
Aaaah right.😂
My EP told me some folk can tolerate Flecainide without a beta blocker but I'd guess thats a low dose only. Yours is a medium as 50mg is lowest issued. As Jim says, Diltiazem is a good partner drug for Flecainide. Take a low dose though because it's a powerful vasodilator and can lower your blood pressure too much. All needs to be discussed with your EP or arrhythmia nurse if you have one.
I'm with MisterMagoo on this one. From the outset 10 yrs ago my cardiologist prescribed just Flecainide same dose as you. No problems. I am now 70 and continue an active life (walking basketball yesterday 😃) with lowish BP & HR.
I have had regular checkups with him and challenged him twice on this, given the usual BB or CB accompanying drug discussed on this forum but his advice remains the same. Two months ago, I saw him & requested a PIP drug in case I went into fast flutter and his advice was the older I get the less likely that is going to occur.
So on we go, best wishes for the right decision for you.
I never feel sure that 1.25mg of bisoprolol is "such a low dose", myself. it's a potent beta-blocker and the dose response curve of the drug has been shown not to be linear. For me, 1.25mg has a broadly similar effect to 2.5mg does in terms of lowering my heart rate and - so far - reducing my episodes of AF. Before I stared taking it daily, about a month ago, a single dose was still affecting me over a day later causing bradycardia.
Steve
I did not know that bisop affected Tinnitus? ( not saying its doesn't, but are you sure its the Bisop?I do know that Flecainide can cause Tinnitus.
If it is the bisop try a beta blocker or a calcium channel blocker as rate control instead.
I know mqny people take flec without rate control, but it gave me re entrant atrial flutter, which fortunately was rate controlled at 140 bpm by the diltiazem I was taking . I was at that rate for a month waiting for an ablation to stop it.
I take flecainide 100mg twice a day and it keeps my heart in order most of the time - I was only advised to take bisoprolol 1.25mg when I took the Flecainide as a PIP and the heart rate exceeded 140 twenty minutes after taking the flecainide. I rarely have need of it now and only had it when I was given a different make of Flecainide rather than the original Accord and thus experienced a few episodes of AF. Do remember that we are all different and I do hope you are able to find what works for you. The amount of bisoprolol you are taking would have finished me off as soon after my diagnosis I had to stop taking just the 1.25 mg daily as it brought my heart rate dangerously low!!
thanks for the reply, I had Bradycardia following a cardio version and now have a pacemaker set at 60bpm that works a treat for me
This is a fascinating thread for me - PAF and had horrid side effects and bradycardia with beta blockers and calc channel blockers. I am a year into flecainide 50mg bd plus apixaban (which is stopped for now ) as now have a suspected GI bleed and in for an endoscopy tomorrow in Hereford . I found on google a rare side effect of flecainide is black stools but the medics yesterday rubbished the query. Has anyone heard of / experienced this ?
Hi
Obviously all our health situations and objectives are individual but I take Flecanide 50+100 each day and only take 2.5 Bisoprol when I have an AF incident (about once a month). Im toying with the idea of going back to 100 x 2 but not considering Biso every day and neither did the cardiologist I spoke to today.
My sleeping HR is 53 so not looking to lower that further
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Switching from Bisoprolol to Verapamil
Reducing Bisoprolol Dosage Post Ablation.
Bisoprolol or Flecainide?
Bisoprolol manufacturer change experience 
